Three-dimensional ultrasound imaging system for prostate cancer diagnosis and treatment

Prostate cancer is the most commonly diagnosed cancer in men in North America. Although two-dimensional (2-D) transrectal ultrasound imaging is widely used for the evaluation of prostate disease, it suffers from limitations that limit its use in diagnosis and therapy of prostate cancer. The use of conventional ultrasound requires that the diagnosticians mentally integrate a series of 2-D images in order to develop an impression of the three-dimensional (3-D) anatomy, and to estimate the volume of the prostate. This approach depends of the expertise of the physician resulting in variability. We have developed a 3-D ultrasound imaging approach that overcomes this problem. In this paper, we describe a 3-D ultrasound imaging system for use in prostate imaging and report on its performance. The system consists of a conventional ultrasound machine, a microcomputer with a video frame grabber, and a custom-built assembly for rotating the ultrasound transducer. A typical scan of 100 2-D B-mode images takes 8 s. These images are then reconstructed into a 3-D image, which can be displayed and interactively manipulated using 3-D visualization software. We also show that manual planimetry of prostates in the 3-D images can be used to estimate volumes in vitro with an accuracy of 2.6%, and a precision of 2.5%; and in vivo with 5.1% intra-observer variability and 11.4% interobserver variability. Thus, 3-D ultrasound imaging overcomes some of the limitations of conventional imaging of the prostate, and has great potential as a tool in the diagnosis and treatment of prostate disease.